Alternatives to Opioids?

Alternatives to Opioids?

One of our author’s own experiences with a painful condition leads to thoughts on alternative treatments

I’m about to visit a pain management clinic for the first time, and I’m not looking forward to it.

I wish I were doing it were for an expose, but I’m not. No, closest to what I can deduce, years of working with my laptop in my lap, for too many hours with few breaks, may have done some damage. I picture the top of my neck and head bent over like the top of a question mark, and I may have paid a price.

So I saw a neurologist for the nerve pain, had a week of steroids, am seeing a physical therapist, and have visited a pain management specialist. The neurologist said not to take Advil every day so I take a couple a week, or maybe I’ll have a Tylenol sometimes. It’s a longer story, but that’s the gist.

I’m telling that story because it makes me wonder—if I end up with prescription pain pills, could that start me on the path to addiction? The PT tells me that if I need them I need them, that I’m not doing myself any favors walking around undermedicated, and that’s what I am doing, she said. But I don’t like medication, and I’m petrified that whatever I get will have bad side effects. I’ve also never taken more than one or two, or maybe three or four, after surgery, and over several days. I hate how they make me feel. Does that mean I’m safe from developing any problem?

This is really an introduction to something I found in a New York Times article: there may be helpful alternatives to opioids. When was the last time you heard such good news? In “A Soldier’s War on Pain,” the writer tells the story of a veteran who saw action in Iraq and Afghanistan and returned from his last deployment with a severely injured foot and other injuries. His wife said that at one point he was taking “pain blockers and narcotics, antidepressants, Concerta for A.D.H.D. They had him on stuff for tremors. Like, I mean, you name it, we had it in our cabinet.”

He had surgery after surgery, but each one failed and after awhile the pain meds didn’t even help, he said. He’d get lethargic and detached due to the high doses he was on. When his 13-year-old daughter told him how distraught she was at the person he had become, he decided to take action. He weaned himself off pain meds.

But it was what he did then that holds hope for others: attended a multidisciplinary pain treatment program at a Florida V.A. hospital. They had him do arts and crafts, for one, and after that he started volunteering in several programs that help other soldiers trying to work through pain and trauma. He joined another therapy program that involved riding horses. And he did it—got off pain pills for good. He has decided to have his foot amputated. I just interviewed a prosthetist for an article who said that people often opt for this after going through years of pain. The serviceman says he doesn’t think he’ll ever be totally pain-free (and right now, neither do I, not that my pain could come close to what he must be experiencing). But the veteran is looking forward to the things he’ll be able to do and it sounds like he’s got his pain under control. If it works for him, it opens doors for others, right?

The article points to a 2008 study by the Mayo Clinic which indicted that when patients were changed from opioids to a non-drug-based program, they had less pain and experienced an improvement in their ability to function. The problem is that not all insurers will pay for these alternative programs. And for our veterans, the Veteran’s Administration program often moves at a very slow pace.